Healthcare Provider Details

I. General information

NPI: 1508010539
Provider Name (Legal Business Name): LYNNETTE BROWN MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 W ROLLING CROSS RD STE 100
CATONSVILLE MD
21228-6280
US

IV. Provider business mailing address

4 W ROLLING CROSS RD STE 100
CATONSVILLE MD
21228-6280
US

V. Phone/Fax

Practice location:
  • Phone: 410-869-0100
  • Fax: 410-601-7317
Mailing address:
  • Phone: 410-869-0100
  • Fax: 410-601-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL31196
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2022-0175
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD2022-0175
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberD76537
License Number StateMD
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD76537
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: